Journal article
Crevice Corrosion Degrades Metaphyseal Sleeves Following Total Knee Arthroplasty: A Retrieval Study
The Journal of arthroplasty, v 40(12), pp 3324-3334
01 Dec 2025
PMID: 40480330
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Surgeons use metaphyseal sleeves in revision total knee arthroplasty (TKA) to compensate for bone loss and improve stability. However, a clinical case series documented corrosion on these devices and associated the subsequent metal release with adverse local tissue reactions. In this study, we investigated corrosion at the mixed-alloy, metaphyseal sleeve–implant interface. We asked the following: (1) How common is corrosion? (2) Does more damage occur at the femoral cobalt chrome alloy (CoCrMo) taper? (3) What damage modes occur?
We analyzed 17 femoral and 15 tibial implant-sleeve components following revision surgery. First, corrosion was classified using the Goldberg score and quantified using the axial corrosion (ΔCmax) on CoCrMo implants. Then, moderately and severely corroded devices were imaged using scanning electron microscopy and energy dispersive X-ray spectroscopy. Differences in corrosion on CoCrMo tibial and femoral implants were assessed using nonparametric statistics.
We observed corrosion on 82% of femoral adapters, 100% of femoral sleeves, 73% of tibial trays, and 86% of tibial sleeves. On CoCrMo femoral adapters, we measured more axial corrosion than on CoCrMo tibial trays (P = 0.04). The predominant damage modes on femoral adapters included pitting, etching, and oxide debris. On titanium alloy femoral sleeves, we documented a burnishing effect, revealing the underlying microstructure.
Our findings indicate that mechanically assisted crevice corrosion promotes metaphyseal implant degradation. Should surgeons encounter patients who have metaphyseal sleeves and unexplained pain or suspected metal release, consider measuring metal concentrations after rigorous rule out of competing diagnoses.
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Details
- Title
- Crevice Corrosion Degrades Metaphyseal Sleeves Following Total Knee Arthroplasty: A Retrieval Study
- Creators
- Shabnam Aslani - Drexel University, School of Biomedical Engineering, Science, and Health SystemsMichael A. Kurtz (Corresponding Author) - Drexel University, School of Biomedical Engineering, Science, and Health SystemsChristopher E. Pelt - University of UtahJoshua P. Rainey - University of UtahMichael J. Archibeck - University of UtahJeremy M. Gililland - University of UtahWilliam A. Sutton - Drexel University, School of Biomedical Engineering, Science, and Health SystemsJames A. Smith - Drexel University, School of Biomedical Engineering, Science, and Health SystemsJeremy L. Gilbert - Clemson UniversitySteven M. Kurtz - Drexel University, School of Biomedical Engineering, Science, and Health Systems
- Publication Details
- The Journal of arthroplasty, v 40(12), pp 3324-3334
- Publisher
- Elsevier Inc
- Number of pages
- 11
- Grant note
- NSF National Nanotechnology Coordinated Infrastructure Program: RRID: SCR_022684
The authors used two scanning electron microscopes in this study, including one at the Drexel University Material Character-ization Core (RRID: SCR_022684) and another at the University of Pennsylvania Singh Center for Nanotechnology (supported by the NSF National Nanotechnology Coordinated Infrastructure Program under grant NNCI-2025608) .
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- School of Biomedical Engineering, Science, and Health Systems
- Web of Science ID
- WOS:001625427200030
- Scopus ID
- 2-s2.0-105009512303
- Other Identifier
- 991022053430904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics